AAPD EBD award nomination form Question Title * 1. The Academy presents an Evidence-Based Dentistry Service Award, only when warranted, to recognize a pediatric dentist(s) who has made a major contribution via service or publication, on a national or international level, to the dental profession and the specialty of pediatric dentistry through evidence-based clinical practice, academics or policy development over the past year. Nominees are solicited from the membership and considered by the Evidence-Based Dentistry Committee (EBDC), which shall make recommendations to the Board of Trustees who shall make the final selection. Teams may apply, such as a systematic review workgroup.Individuals applying or being nominated for this award must: 1. Demonstrate through service or publication an extraordinary contribution to EBD;2. Submit a letter from peer or patient attesting to the nominees contribution;3. Provide proof of at least one peer-reviewed published EBD paper;4. Submit a C.V. demonstrating ongoing dedication to EBD practice and principles;5. Be a current member of the AAPD.* We will contact you after the nomination is submitted.Due 02/28/2018Enter your nominee's name below: OK Question Title * 2. Enter your contact information below: OK DONE